27 Apr PCOS – What’s Your Type?
PCOS or polycystic ovarian syndrome is a syndrome, which means a collection of symptoms, of which each individual may be suffering from several at the same time
The main criteria to be diagnosed with PCOS is that you have androgen excess, if this is not the case then you don’t have PCOS.
Identifying the type of PCOS is beneficial as there are different symptoms and drivers for each and they may even overlap.
The four different types of PCOS
1. INSULIN RESISTANT (Classical PCOS)
This is the main type of PCOS accounting for approximately 70% of cases
This is where high levels of insulin can impair ovulation and stimulate the ovaries to make more testosterone instead of oestrogen (this is a prediabetic sign).
Irregular cycles are common as well as excessive hair growth (due to high androgens).
It can also stimulate your pituitary to make more Luteinising hormone. Increasing insulin sensitivity (to reverse insulin resistance) and balancing blood sugar is important for treatment. This is possible with a combination of diet, exercise, and specific supplements.
While weight gain can be a symptom of PCOS (especially with the insulin-resistant type of PCOS), it’s entirely possible to have a lean type of PCOS in a lean body as well.
2. INFLAMMATORY PCOS
With an inflammatory type of PCOS, you can see just that – inflammation in the body. Signs in your body of inflammation include digestive issues like IBS, unexplained fatigue, headaches, joint pain, skin conditions like eczema or psoriasis, or even food sensitivities.
You can test a marker called high sensitivity C-reactive protein (hsCRP) and ESR to check for the level of inflammation in your body if you suspect you may have an inflammatory type of PCOS.
Women with this type of PCOS often have infections, thyroid imbalances, leaky gut, or gluten intolerance. Women with a family history of autoimmune disorders may be at higher risk for inflammatory PCOS.
3. POST-PILL PCOS
If your periods were normal before taking hormonal birth control and now you meet the diagnostic criteria for PCOS you may have the post-pill type of PCOS. If you had experienced PCOS symptoms before going on the pill but never received a formal diagnosis it’s possible you had PCOS before going on the pill.
It is common to experience a temporary surge in androgens particularly with OCPs such as Yasmin, Yas, Diane or Brenda.
This is part of a temporary pill withdrawal and can be supported by using anti-androgen supplements.
Hormonal birth control disrupts the healthy signalling of the HPO (hypothalamic-pituitary-ovarian) axis which can make it hard to resume ovulation once stopping the pill.
4. ADRENAL TYPE OF PCOS
If DHEA-S is your only high androgen this can indicate an adrenal type of PCOS as DHEA-S is your adrenal androgen (testosterone is produced in the ovaries).
With this one, you want to check your prolactin levels to rule out another condition that presents similarly to PCOS called non-classic congenital adrenal hyperplasia (NCAH).
The adrenal type of PCOS is driven by an abnormal stress response versus an impaired insulin or blood sugar response as seen in the insulin-resistant type of PCOS. The divers may be insufficient caloric intake, chronic stress, extreme workouts and cortisol dysregulation
5. NON-ANDROGENIC PCOS
This is when women of normal weight and no hyperandrogenism but has Oligomenorrhea (infrequent menstrual periods) and Polycystic ovaries on ultrasound. This is a medical diagnosis.
Polycystic ovary syndrome (PCOS) cannot be diagnosed by ultrasound because polycystic ovaries are not cysts. They’re follicles or eggs which are normal for the ovary. It’s normal for young women to always have a higher number of follicles because young women have more eggs.
The hidden cause of PCOS
Other drivers that can result in a hidden cause type of PCOS include thyroid disease because hypothyroidism affects ovulation and can worsen insulin resistance. Deficiencies in vitamin D, zinc, or iodine (all essential for ovarian health) or elevated prolactin can increase DHEA. With these hidden drivers, once you fix the root cause your symptoms should improve quickly.
At NatMed we partner with women like you who have been told their pathology tests are normal but they know something is wrong with their hormones.
We offer speciality hormone testing not available in the standard doctor’s office and create a plan that uses food, lifestyle, and supplement recommendations to fix your hormone imbalance.
Advanced Hormone Testing
The DUTCH test is the gold standard for Functional Pathology hormone testing. It is an at-home comprehensive hormone test that measures your sex hormones, adrenal (stress) hormones, and nutrition & mood chemical markers.
In addition to hormone levels, we also take a look at breakdown products of metabolism (metabolites), which give us more information about potential imbalances. Instead of just knowing WHAT is out of balance, these markers give us some insights as to WHY.
This includes :
– estrogen & metabolites
– progesterone & metabolites
– androgens & metabolites
– cortisol & metabolites
– free cortisol & cortisone patterns
– DHEA-S
– melatonin
– mood chemical markers: dopamine & norepinephrine/epinephrine
– nutritional markers: vitamin B12, vitamin B6, glutathione
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